House rules: Virginia won’t expand ‘broken’ Medicaid in ‘14


HOLD THE PHONE: State Delegate Steve Landes says House Republicans will not approve Medicaid expansion this year.

By Kenric Ward | Virginia Bureau

RICHMOND, Va. — Encircled by Democrats pushing hard for Medicaid expansion, the Republican-controlled House of Delegates is stiffening its spine in opposition.

“Medicaid is a complicated system with a lot of moving parts — and the dollars keep changing,” cautions state Delegate Steve Landes.

The vice chairman of the state Medicaid Innovation and Reform Commission told Watchdog that no one — including Gov. Terry McAuliffe — knows the fiscal impact of expanding the multibillion-dollar indigent-care program in Virginia.

McAuliffe has said the commonwealth is losing $5 million every day it does not add 400,000 poor Virginians to its Medicaid rolls. The newly organized Democratic Senate is ready to sign on.

The Virginia Hospital and Healthcare Association is also pressing for expansion, and has the ear of Emmett Hanger, a Republican senator who chairs the MIRC.

But House Republicans, wielding a veto-proof majority, want an external audit before proceeding. They say they will not consider any budget amendments from the governor that would expand Medicaid this year.

GOP Delegate John O’Bannon, a Henrico County physician, says taxpayers would be best served if Virginia examined other states’ experiences first. “Better to be a good imitator, rather than a risky innovator,” he said.

State Health and Human Services Secretary Don Hazel‘s Medicaid-cost projections have swung $3 billion in the past year.

“This makes the case for no Medicaid expansion,” said O’Bannon, who debunked the claims that Virginia’s hospitals are reeling financially from Medicaid.

“VCU had $170 million operating margin last year. Inova (Health System) has $1.1 billion in its foundation. This is not an emergency or a crisis,” he said.

An audit by former Gov. Bob McDonnell’s administration found $1.5 billion in potential savings in the state’s nearly $4 billion Medicaid budget.

Hazel has estimated that one of every three Medicaid dollars is lost through fraud — and costs have been soaring: up 19.9 percent from fiscal 2011 to fiscal 2012.

“We have never looked in-depth at the Medicaid system from the outside,” Landes, R-Verona, said. “MIRC hasn’t even finished its work, and it won’t be completed until end of 2014.”

The panel’s initial findings are not encouraging.

“Perhaps the most important thing I have learned is that Medicaid is more fundamentally broken that we originally thought,” Landes said.

The House Rules Committee on Friday approved Joint Resolution 40, authorizing an audit into Medicaid-funded transportation services, with a deadline to report no later than the first day of the 2015 General Assembly.

Meanwhile, Obamacare regulations that affect Medicaid keep changing with waivers and delays from Washington.

Rebutting McAuliffe’s assertion that Virginia will receive billions from the federal government for expanding Medicaid, Landes said, “We don’t believe federal funds will be there in the long term.”

“It’s foolish to think that the ‘free’ cash will last,” writers of a Washington Times editorial agreed. “Once the feds turn off the spigot, the state would have to find a way to pay the $2 billion annual bill.

“Further expanding a program hurtling toward insolvency would be the height of irresponsibility.”

Kenric Ward is a national reporter for and chief of the Virginia Bureau. Contact him at or at (571) 319-9824. @Kenricward

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